Bacteremia after endoscopic injection of N-butyl-2-cyanoacrylate for gastric variceal bleeding.
Bacteremia after endoscopic injection of N-butyl-2-cyanoacrylate for gastric variceal bleeding.
复制标题
内镜下注射 N-丁基-2-氰基丙烯酸酯治疗胃静脉曲张出血后出现菌血症。
DOI：
10.1067/mge.2001.116566
复制
发表时间：
2001
影响因子：
7.7
通讯作者：
Shou
中科院分区：
文献类型：
--
作者：
Wen;M. Hou;Han‐Chieh Lin;K. Yu;F. Lee;F. Chang;Shou
背景
氰基丙烯酸酯在用于组织时可形成防止细菌侵入的屏障。由于氰基丙烯酸酯在与水性介质接触时在几秒钟内聚合，因此它在世界范围内用于阻止胃静脉曲张出血。本研究的目的是确定内镜下氰基丙烯酸酯注射治疗胃静脉曲张出血后菌血症的发生率。
方法
纳入了接受内镜下氰基丙烯酸酯注射治疗胃静脉曲张出血的肝硬化患者。招募因非静脉曲张性上消化道出血而接受上消化道内镜检查的肝硬化患者作为对照组。排除内镜检查前有感染的患者。两组均进行血液培养。氰基丙烯酸酯注射组培养注射针和内窥镜辅助通道。
结果
与对照组相比，注射氰基丙烯酸酯的更多患者具有阳性血培养（15/47 vs. 1/47，p < 0.0001）。氰基丙烯酸酯注射液组中，输血量和Child-Pugh评分是发生菌血症的相关因素。大多数菌血症发作是短暂的，除了1例死于败血症。从血液样品中培养的大多数微生物与从注射针（65%）和辅助通道（90%）中培养的微生物相同。
结论
内镜下氰基丙烯酸酯注射治疗胃静脉曲张不能限制细菌的传播。内镜附件通道是主要的细菌来源。大多数菌血症发作是短暂的，平安无事。
BACKGROUND
Cyanoacrylate may form a barrier that prevents bacterial invasion when used in tissue. Because cyanoacrylate polymerizes within seconds on contact with aqueous media, it is used worldwide to arrest gastric variceal bleeding. The aim of this study was to determine the frequency of bacteremia after endoscopic cyanoacrylate injection for gastric variceal bleeding.
METHODS
Patients with cirrhosis who underwent endoscopic cyanoacrylate injection for gastric variceal bleeding were included. Patients with cirrhosis who underwent upper endoscopy for nonvariceal upper GI bleeding were recruited as controls. Patients with infection before endoscopy were excluded. Blood was cultured in both groups. Injection needles and endoscope accessory channels were cultured in the cyanoacrylate injection group.
RESULTS
More patients injected with cyanoacrylate had positive blood cultures in comparison with the control group (15/47 vs. 1/47, p < 0.0001). In the cyanoacrylate injection group, the volume of blood transfused and Child-Pugh score were factors associated with the occurrence of bacteremia. Most episodes of bacteremia were transient, except for 1 patient who died of sepsis. Most of the microorganisms cultured from blood samples were identical to those cultured from injection needles (65%) and accessory channels (90%).
CONCLUSIONS
Endoscopic cyanoacrylate injection for gastric varices does not limit the spread of bacteria. The endoscope accessory channel was the major source of bacteria. Most episodes of bacteremia were transient and uneventful.
影响因子：
8.8
作者：
DEITCH, EA;MORRISON, J;SPECIAN, RD
通讯作者：
SPECIAN, RD